Ordeal of Postpartum Psychosis : Illness Can Have Tragic Consequences for New Mothers

SACRAMENTO — Angela Thompson was unusually preoccupied the last week of August, 1983. She and her husband, Jeff, had friends over for dinner and she barely said a sentence. Sometimes she looked at Jeff across the table as if asking for a cue as to how to behave.

In the following days she cooked the meals, washed the dishes and cared for the couple's 3-year-old daughter, Allyson, and their 9-month-old son, Michael. But Angela Thompson had the quiet air of someone making plans, someone with a secret mission.

When Jeff Thompson left for work the morning of Sept. 1, his wife was preparing stew for that evening's dinner. She chopped, stirred and schemed:

. . . The baby is the devil. . . . If I kill the demon, my husband will raise the baby to life again in three days, and the world will know he is Jesus Christ . . . .

When Angela met her husband at the front door at 6:45 that evening, her eyes were glassy, her pupils dilated. Her expression, he said later, was like a pet dog who is unsure whether it's done something good or bad--but is looking for approval anyway.

"Jeff, I have to say something," Angela said. She was shaking. "Michael's dead."

Jeff searched his wife's face to see if she could possibly mean what she'd said. Then he charged through the house, going first to his daughter's room. Allyson was standing on her bed, looking perplexed.

Some impulse made him run outside. There, along the side of the house, he found his baby boy in a box, covered with a towel.

He picked the body up and hugged it to him. Then he went inside and dialed the police. He gave his address and said, "My son is dead."

If the Thompsons had been living in England instead of Davis, Calif., at the time, Michael's death would have come under the Infanticide Act of 1938, which states that in the first 12 months after she gives birth, a woman cannot be charged with the murder of her infant (she can be charged with the lesser offense of manslaughter).

The British law tacitly acknowledges the existence of a condition called postpartum psychosis: "The balance of (the mother's) mind was disturbed by reason of her not having fully recovered from the effect of giving birth," it reads.

According to two psychiatrists interviewed for this story, there is inadequate recognition of postpartum psychosis among medical professionals in this country. If diagnosed, the condition is readily controlled by hospitalization and drug or electroshock therapy, the psychiatrists said. Untreated, however, the psychosis can become so severe as to cause the mother to commit suicide or infanticide.

Caused by Hormonal Changes

The illness is a temporary condition that occurs in new mothers (the majority of whom have no prior history of mental illness) due to hormonal changes that are not yet completely understood, said San Francisco psychiatrist Dr. James Hamilton, who has treated more than 300 such cases.

He cautioned that when the illness is used as a defense for infanticide, "One needs to have a certain amount of evidence of some sort that this is indeed a psychosis. It would be a disservice to sick people if a lot of non-sick people who are just garden-variety child abusers got under this wire."

Child abuse, not postpartum psychosis, was indeed the explanation that local newspapers gave for the death of Michael Thompson. Angela Thompson was charged with first-degree murder. (She drowned the infant in the bathtub; her psychotic reasoning for the act, as she described it in an interview, is spelled out in the italicized paragraphs above.)

In the months after Michael died, Angela was held in two different mental hospitals. She then was released to spend six months at her parents' house in Salinas. (The $250,000 bail was reduced on the condition that Angela would leave town; she was at that time seen as a menace to the community, Jeff said.)

The charges were eventually reduced to manslaughter and felony child abuse. Angela was acquitted by reason of insanity. She was ordered into inpatient treatment at a halfway house for 90 days, then was allowed to go home as long as she met conditions set by the court. For as many as six more years, she must meet these conditions, which include regular visits with a psychiatrist.

Now that several years have passed since Michael's death, Angela and Jeff Thompson said that they are working to alert new parents and health professionals that postpartum psychosis must be recognized and treated if future tragedies are to be averted. They are operating alone for the moment, they said, but hope someday to be part of a network of people concerned with postpartum psychiatric illness.